Gyung-Min Park

Prevalence and Clinical Implications of Newly Revealed, Asymptomatic Abnormal Ankle-Brachial Index in Patients With Significant Coronary Artery Disease

OBJECTIVESnThis study sought to evaluate the association between newly revealed abnormal ankle-brachial index (ABI) and clinical outcomes in patients with significant coronary artery stenosis.nnnBACKGROUNDnLittle is known about the prevalence and clinical implications of ABI in patients with no claudication or previous history of peripheral artery disease who undergo diagnostic coronary angiography.nnnMETHODSnBetween January 1, 2006, and December 31, 2009, ABI was evaluated in 2,543 consecutive patients with no clinical history of claudication or peripheral artery disease who underwent diagnostic coronary angiography. Abnormal ABI was defined as ≤0.9 or ≥1.4. The primary endpoint was the composite of death, myocardial infarction, and stroke over 3 years.nnnRESULTSnOf the 2,543 patients, 390 (15.3%) had abnormal ABI. Of the 2,424 patients with at least 1xa0significant stenosis (≥50%) in a major epicardial coronary artery, 385 (15.9%) had abnormal ABI, including 348 (14.4%) with ABI ≤0.9 and 37 (1.5%) with ABI ≥1.4. During a median follow-up of 986xa0days, the 3-year major adverse event rate was significantly higher in patients with abnormal than normal ABI (15.7% vs. 3.3%, p < 0.001). After multivariate analysis, abnormal ABI was identified as a predictor of primary endpoint (hazard ratio [HR]: 1.87; 95% confidence interval [CI]: 1.23 to 2.84; pxa0=xa00.004). After adjustment by propensity-score matching, abnormal ABI could predict adverse clinical events in patients with established coronary artery disease (HR: 2.40; 95% CI: 1.41 to 4.10; pxa0=xa00.001).nnnCONCLUSIONSnThe prevalence of newly revealed abnormal, asymptomatic ABI among patients who have significant CAD on coronary angiography was 15.9%. The presence of abnormal ABI was associated with a higher incidence of adverse clinical outcomes over 3 years.

VALIDATION OF THE GLOBAL RISK CLASSIFICATION FOR PREDICTION OF LONG-TERM OUTCOME AFTER UNPROTECTED LEFT MAIN CORONARY REVASCULARIZATION

The global risk classification (GRC) was created to incorporate clinical variables into angiographic SYNTAX score by combination with EuroSCORE. This study aimed to validate the ability of the GRC score to predict long-term outcome in patients underwent unprotected left main coronary artery (ULMCA)

DISTRIBUTION OF CORONARY ARTERY CALCIUM SCORE AND PREVALENCE OF CORONARY ARTERY DISEASE ACCORDING TO FRAMINGHAM RISK STRATA IN ASYMPTOMATIC KOREAN ADULTS

Background: Coronary artery calcium score (CACS) and coronary computed tomography angiography (CCTA) have been proposed as possible way to screen of coronary artery disease (CAD) beyond Framingham risk strata (FRS). However, current guidelines recommended CACS screening only in intermediate-risk groups (FRS, 10% to 20%). Thus, we aimed to evaluate the distribution of CACS and the prevalence of CAD across FRS, and also determine whether lower-risk population could benefit from screening of CACS and CCTA.